This trial is a prospective multi-center study. The purpose of this study is to evaluate the effect of dietary supplement combined with supervised exercised on the physical performance, body composition and lung function among patients with Sarcopenia and severe Sarcopenia in chronic lung disease. After participants enroll in this study, 12-week clinical trial will be conducted to analyze the improvement regarding Sarcopenia and different severity of Sarcopenia before and after the intervention of exercise and nutritional products, which can further provide reference for clinical intervention and rehabilitation.
The design of clinical trial This study is a prospective, multi-center, and non-invasive cohort study. All participants are diagnosed with COPD or ILD with Sarcopenia or severe Sarcopenia. The intervention consisted of providing nutritional supplements and supervised exercise for 12 weeks. After the intervention (the 12th week), the trial commissioned company provides nutritional supplements with a market price of about NT$4,000 per month for three months free to participants who are willing to continue taking the products. Those participants will be tracked for one year. The primary purpose of the study is to investigate improvement of physical performance, body composition and lung function before and after the intervention. The secondary purpose of the study is to compare the effect of the same intervention on Sarcopenia and different severity of Sarcopenia regarding the improvement of physical performance, body composition and lung function. Furthermore, the subgroup analysis is conducted to compare those who achieve the exercise requirement with those who do not concerning their physical performance, body composition and lung function. Trail procedures 1. Baseline demographic characteristic, health behavior and exercise habits are collected by questionnaires. 2. The main disease diagnosis, medication, clinical assessment questionnaire or biochemical examination and radiological examination results are collected. 3. According to the 2019 Asian Sarcopenia Consensus, participants are examined by SARC-Calf questionnaire, grip strength test and a physical performance test, including sit-stand test, short physical performance battery (SPPB), gait speed test and six-minute walk test. Afterward, bioelectrical impedance analysis (BIA) and Dual-energy X-ray absorptiometry (DXA) are applied to all participants to analyze body composition. Participants are classified into Sarcopenia group and severe Sarcopenia group. 4. All patients receive pulmonary function test and blood test ( complete blood count, hepatic function, including \[CHOL、TG、UA、SGOT、SGPT、ALK、BIL、TOTAL.BIL、DIRECT、LDH\], renal function \[BUN、CREAT、CA、CL、NA、K、T、P、ALB\], Albumin, Vitamin D before and after the trail. 5. All participants are administered Sarcojoint® containing leucinine 1 g, arginine 1.5 g, Vitamin D 7.5μg, chondroitin 400 mg, calcium 300 mg, and glucosamine 700 mg per package, and take 1 package twice a day. 6. All participants are required to walk 6500 steps every day for 12 weeks, and the data are recorded by Xiaomi-smart-band. 7. The research nurse provides health education and a recording handbook for exercise and dietary record to participants before the intervention. During the intervention, the research nurse tracks participants' compliance and records the adverse reaction by telephone interview at the first week, and every other week. 8. At the 12th week, all participants receive a comprehensive functional assessment as that at baseline after intervention to investigate the intervention effect on different severity of Sarcopenia. 9. At the 12th week, trial commissioned manufacturer provide nutritional supplements free for 3 months. Those patients will be continuously tracked for the follow-up data for the post hoc analysis.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
SUPPORTIVE_CARE
Masking
NONE
Enrollment
100
All participants are administered Sarcojoint® containing leucinine 1 g, arginine 1.5 g, Vitamin D 7.5μg, chondroitin 400 mg, calcium 300 mg, and glucosamine 700 mg per package, and take 1 package twice a day.
All participants are required to walk 6500 steps every day for 12 weeks, and the data are recorded by Xiaomi-smart-band.
Taichung Veterans General Hospital
Taichung, Taiwan
RECRUITINGChange of physical performance (Grip strength)
Grip strength (kg) Instrument: Smedley dynamometer
Time frame: 12 weeks
Change of physical performance(Sit to stand test) :SpO2%, HR, Borg score, times and second will be reported to present the result of Sit to stand test.
SpO2%, HR, Borg score, times and second
Time frame: 12 weeks
Change of physical performance (SPPB): Sit to stand test, balance test and 4-meter walk test will be combined to report SPPB score
Sit to stand test, balance test and 4-meter walk test will be combined to report SPPB score
Time frame: 12 weeks
Change of physical performance :6-meter walk test (second)
5\. 6-miniute walk test ( SpO2%, HR, Borg score, and the walking distance will be reported to present the result of 6-miniute walk test. )
Time frame: 12 weeks
Change of physical performance :6-miniute walk test ( SpO2%, HR, Borg score, and the walking distance will be reported to present the result of 6-miniute walk test. )
SpO2%, HR, Borg score, and the walking distance
Time frame: 12 weeks
Change of body composition: BMI(kg/m^2)
Time frame: 12 weeks
Change of body composition: SMI (kg/m^2)
PBF (%), ASM (kg), LMM (kg), BMD (T-score), RASM (kg/m\^2)
Time frame: 12 weeks
PBF (%)
Change of body composition
Time frame: 12 weeks
ASM (kg)
Change of body composition
Time frame: 12 weeks
LMM (kg)
Change of body composition
Time frame: 12 weeks
BMD (T-score)
Change of body composition
Time frame: 12 weeks
RASM (kg/m^2)
Change of body composition
Time frame: 12 weeks
Forced Expiratory Volume in 1 second(FEV1(L))
Change of lung function
Time frame: 12 weeks
Forced Expiratory Volume in 1 second as a percentage of predicted value(FEV1 (%))
Change of lung function
Time frame: 12 weeks
ratio of Forced Expiratory Volume in 1 second to Forced Vital Capacity as a percentage(FEV1/FVC (%))
Change of lung function
Time frame: 12 weeks
Peak Expiratory Flow(PEF (L/min))
Change of lung function
Time frame: 12 weeks
RBC (/μL)
Complete blood count
Time frame: 12 weeks
WBC (/μL)
Complete blood count
Time frame: 12 weeks
PLT (/μL)
Complete blood count
Time frame: 12 weeks
Hb
Complete blood count
Time frame: 12 weeks
Hematocrit
Complete blood count
Time frame: 12 weeks
TG
Hepatic function
Time frame: 12 weeks
SGOT (U/L)
Hepatic function
Time frame: 12 weeks
SGPT (U/L)
Hepatic function
Time frame: 12 weeks
Total cholesterol(mg/dL)
Hepatic function
Time frame: 12 weeks
LDL-C (mg/dL)
LDL-C (mg/dL)
Time frame: 12 weeks
Fasting glucose (mg/dL)
Fasting glucose (mg/dL)
Time frame: 12 weeks
HbA1c (%)
HbA1c (%)
Time frame: 12 weeks
Total protein (g/dL)
Total protein (g/dL)
Time frame: 12 weeks
Albumin (g/dL)
Albumin (g/dL)
Time frame: 12 weeks
Renal function
BUN、CREAT(mg/dL)
Time frame: 12 weeks
Hs-CRP
Hs-CRP
Time frame: 12 weeks
Vitamin D
Vitamin D
Time frame: 12 weeks
SARC-Calf questionnaire
compare the effect of the same intervention on Sarcopenia and different severity of Sarcopenia.
Time frame: 12 weeks
Grip strength test
compare the outcome of physical performance of the same intervention on Sarcopenia and different severity of Sarcopenia.
Time frame: 12 weeks
Sit-stand test
compare the outcome of physical performance of the same intervention on Sarcopenia and different severity of Sarcopenia.
Time frame: 12 weeks
Short physical performance battery (SPPB)
compare the outcome of physical performance of the same intervention on Sarcopenia and different severity of Sarcopenia.
Time frame: 12 weeks
Gait speed test
compare the outcome of physical performance of the same intervention on Sarcopenia and different severity of Sarcopenia.
Time frame: 12 weeks
Six-minute walk test.
compare the outcome of physical performance of the same intervention on Sarcopenia and different severity of Sarcopenia.
Time frame: 12 weeks
Bioelectrical impedance analysis (BIA)
compare the effect of the same intervention on Sarcopenia and different severity of Sarcopenia on the outcome of body composition
Time frame: 12 weeks
SMI (kg/m^2)
DXA is an X-ray machine that can generate two types of low-energy X-rays. X-rays of different energies are attenuated to different degrees by different media. The higher the density of the medium, the greater the attenuation caused by X-rays. Through computer calculations, DXA can not only measure bone density but also analyze body composition, determining the quantity and ratio of muscle and fat. Bone density: L-spine (g/cm\^2) and T-score , Femoral neck (g/cm\^2) and T-score
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Time frame: 12 weeks
Forced Expiratory Volume in 1 second (FEV1)
Pulmonary function
Time frame: 12 weeks
Forced Expiratory Volume in 1 second as a percentage of predicted value (FEV1 (%))
Pulmonary function
Time frame: 12 weeks
ratio of Forced Expiratory Volume in 1 second to Forced Vital Capacity as a percentage (FEV1/FVC (%))
Pulmonary function
Time frame: 12 weeks
Peak Expiratory Flow (PEF (L/min))
Pulmonary function
Time frame: 12 weeks